Case Management is a dynamic process that assesses, plans, implements, coordinates, monitors, and evaluates to improve outcomes, experiences, and value.
The practice of case management is professional and collaborative, occurring in a variety of settings where medical care, mental health care, and social supports are delivered. Services are facilitated by diverse disciplines in conjunction with the care recipient and their support system.
In pursuit of health equity, priorities include identifying needs, ensuring appropriate access to resources/services, addressing social determinants of health and facilitating safe care transitions. Professional case managers help navigate complex systems to achieve mutual goals, advocate for those they serve, and recognize personal dignity, autonomy, and the right to self-determination.
(ACMA/CCMC September 2022)
To obtain optimum value for clients and reimbursement sources, case managers identify appropriate providers and facilities across the continuum of health care and human services while ensuring that available resources are timely, cost-effective, and efficient. Take a look into today's case manager in our CCM Insights eBook, "Growth, Benefits and Value: Insight into Today’s CCM."
Case managers help all healthcare stakeholders.
The benefits of case management accrue to all participants in the process. Consumers gain an advocate and emotional support. Physicians and hospitals have complex cases facilitated. And payers' costs are reduced while their customers are retained.
Four important factors will continue to impact the practice of case management.
- Explosion of managed care.
- Burgeoning elder population.
- Increasing number of chronically ill patients maintaining an improved quality of life through newly developed drugs and requiring complex, ongoing treatment.
- Spread of state legislation requiring certification and licensing.
Case management practice will continue to grow. Become a certified leader.
Advances in healthcare technology combined with diminishing resources increases the demand for certified case managers who can manage complex cases in the best interests of consumers while saving time and money.